ATT 6_PPQ.docx

RFP 24361821R0002 BENEFEDS

ATTACHMENT 6

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

INSTRUCTIONS TO OFFERORS SENDING REFERENCE QUESTIONNAIRE FORMS:

Section A (Part I and Part II) shall be completed by the offeror (the firm requesting the reference) prior to issuing the questionnaires. The offeror shall send the questionnaires for relevant projects, that are in progress or completed in the past ten (10) years, to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for Government contracts. The reference shall send the completed questionnaire to the email address identified below. OPM will not accept questionnaires submitted directly to OPM by the offeror. Only questionnaires submitted from the offeror’s reference will be accepted. It is the responsibility of the offeror to follow-up and to encourage references to submit the questionnaire to OPM. The completed questionnaire shall be submitted via e-mail directly from the person providing the reference. The Offeror SHALL NOT pre-fill Section B for the reference to simply sign. The Government reserves the right to disqualify offeror’s PPQs which appear to have been pre-filled by the Offeror in Section B.

INSTRUCTIONS TO PERSON PROVIDING REFERENCE:

In order to assess potential vendors under OPM’s BENEFEDS ENROLLMENT AND PREMIUM ADMINISTRATION SERVICES acquisition, OPM is seeking past performance information with respect to each offeror. As a reference for work performed by the firm identified in Section A of this questionnaire, your candid response will assist in the evaluation process.

Please complete Section B (Part I and Part II) of the questionnaire as thoroughly as possible. Please submit both Sections A and B of this questionnaire via email to Shireen.Belanger@opm.gov, no later than 2:00 PM Eastern Time (ET) on March 17, 2022. The subject line in the submission e-mail shall clearly indicate: “BENEFEDS PPQ for <Company Name>”, and the message shall originate from the reference’s Government or commercial e-mail account.

Please include both Sections A and B of the questionnaire in your submission. Please sign where indicated at the end of Section B, either wet ink or electronically (if the electronic signature includes a digital ID certificate). Do not simply use a script font to type your name in lieu of an electronic or wet ink signature. Please contact Shireen.Belanger@opm.gov if you do not have the means to submit a scanned wet ink or digital ID electronic signature.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. This is a major acquisition within OPM and your input into this evaluation is greatly appreciated. If you have questions regarding this questionnaire or require assistance, please submit inquiries to Shireen.Belanger@opm.gov.

Sincerely, Shireen Belanger, Contract Specialist

RFP 24361821R0002 BENEFEDS

SECTION A – to be completed by the Offeror

PART I: OFFEROR INFORMATION

COMPANY NAME AND DIVISION NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT & CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):

TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID, SOLE SOURCE):

PRICING TYPE: (Check all that apply)

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

· INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS):

· FINAL CONTRACT DOLLAR VALUE (W/OPTIONS), as modified:

ROLE ON PROJECT:

_____Prime _____Subcontractor (explain type and extent of subcontracting, if applicable):_________________________ _____Other (explain):______________________________________________________________________

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

SECTION B - to be completed by Evaluator (person providing reference)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE (e.g. CONTRACTING OFFICER (CO), CONTRACTING OFFICERS REPRESENTATIVE (COR), PROGRAM MANAGER (PM)):

ADDRESS:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:

Exceptional/ High Confidence Based on the offeror’s performance record, the offeror exceeded many of the Government requirements, few minor problems and was highly effective in taking corrective action; essentially no doubt exists that the offeror will successfully perform the required effort.

Very Good/ Significant Confidence Based on the offeror’s performance record, the offeror exceeded some of the Government requirements, some minor problems and was effective in taking corrective action; little doubt exists that the offeror will successfully perform the required effort.

Satisfactory/ Confidence Based on the offeror’s performance record, the offeror met all of the Government’s requirements, some minor problems and was satisfactory in taking corrective action; some doubt exists that the offeror will successfully perform the required effort.

Neutral/ Unknown Confidence No performance record identifiable.

Marginal/ Little Confidence Based on the offeror’s performance record, the offeror did not meet some of the Government’s requirements, serious (recoverable) problems and was marginally effective in taking corrective action; substantial doubt exists that the offeror will successfully perform the required effort. Changes to the offeror’s existing processes may be necessary in order to achieve contract requirements.

Unsatisfactory/ No Confidence Based on the offeror’s performance record, the offeror did not meet most of the Government’s requirements, serious (non-recoverable) problems and was ineffective in taking corrective action extreme doubt exists that the offeror will successfully perform the required effort.

QUALITY OF PRODUCT OR SERVICE

1. The Contractor provided a product or service that conformed to contract requirements, specifications, and standards of good workmanship (e.g. commonly accepted technical, professional, environmental, or safety and health standards).

2. The Contractor submitted accurate reports.

3. The Contractor utilized personnel that were appropriate to the effort performed.

COST CONTROL

1. The Contractor performed the effort within the estimated cost/price.

2. The Contractor demonstrated cost efficiencies in performing the required effort.

3. The actual costs/rates realized closely reflected the quoted or proposed costs/rates.

SCHEDULE

1. The tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract.

2. The Contractor was responsive to technical and/or contractual direction.

BUSINESS RELATIONSHIPS

1. The Contractor presented information and correspondence in a clear, concise, and businesslike manner.

2. The Contractor promptly notified the COR, TPOC, and/or Contracting Officer in a timely manner regarding urgent issues.

3. The Contractor made timely award and demonstrated effective management of its subcontractors.

4. The products/services provided adequately met the needs of the program.

5. The Contractor was able to perform with minimal or no direction from the COR or the TPOC.

MANAGEMENT

1. The Contractor demonstrated effective management over the effort performed.

2. The Contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

3. The Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical program issues

4. The Contractor submitted accurate invoices on a timely basis.

5. The Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) and/or Technical Point of Contact (TPOC) were apprised of the technical, cost/price and schedule issues.

UTILIZATION OF SMALL BUSINESS (Respond only if was large Business) FAR Subpart 19.7 and 15 U.S.C. 637 contains statutory requirements for complying with the Small Business subcontracting Program.

1. Assess whether the Contractor provided maximum practicable opportunity for small business to participate in contract performance consistent with efficient performance of the contract.

Additional comments you would like to share:

SIGNATURE:

TITLE:

DATE: